Trends In Incidence Of AIDS-Defining And Non-AIDS-Defining Cancers In Persons With AIDS: A Population-Based Study From São Paulo, Brazil

Luana TANAKA, School of Public Health, University of São Paulo, Brazil
LATORRE M. 1,3 , GUTIERREZ E. 4 , HEUMANN C. 5 , HERBINGER K. 6 , FROESCHL G. 2,6

1 Department of Epidemiology, School of Public Health, University of São Paulo, Brazil
2 Center for International Health, Medical Center of the University of Munich, Munich, Germany
3 Population-based Cancer Registry of São Paulo, Department of Epidemiology, University of São Paulo, São Paulo, Brazil
4 Programa Municipal DST-AIDS, Secretaria Municipal de Saúde, São Paulo, Brazil
5 Institute of Statistics, University of Munich, Munich, Germany
6 Department of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich, Munich, Germany

Purpose: Several studies have shown increased risk for cancer among people with HIV/AIDS; however, risk has changed over time. Our study is analysing trends in AIDS-defining (ADC) and non-AIDS-defining cancers (NADC) among persons with AIDS in São Paulo, Brazil, between 1997 and 2012.
Methods: We conducted a population-based registry linkage study. We linked the Population-based Cancer Registry of São Paulo (496,276 cancers) and the AIDS notification database (81,889 AIDS cases) to identify persons with AIDS who had cancer. To analyse cancer trends we estimated the annual percent change.
Results: Among persons with AIDS 2,074 cancer cases were diagnosed (1,510; 72.8% in men),   of which 51.0% (1,057) were NADC. In men, the most frequent were Kaposi sarcoma (KS; 469; 31.1%) and non-Hodgkin lymphoma (NHL; 304; 20.1%), followed by cancers of anus (63; 4.2%), of colon-rectum (59; 3.9%), and of lung (54; 3.6%). ADC, KS, NHL decreased -14.1%, -17.7% and -11.9%/year, respectively. NADC have increased (7.4%/year) since the mid 2000’s driven by the upward trends of anal (24.6%/year) and lung cancers (15.9%/year). Among women, the most incident cancers were cervical cancer (CC; 114; 20.2%), NHL (96; 17.0%), breast cancer (72; 12.8%), KS (34; 6.0%) and colorectal cancer (19; 3.4%). Declining trends were found for ADC (-15.6%/year), KS (-26.7%/year), NHL (-15.8%/year), CC (-12.8%/year), NADC (-15.8%/year) and breast cancer (-10.1%/year), whereas, colorectal cancer remained stable.
Conclusions: Trends in cancers among persons with AIDS in São Paulo, Brazil showed similar patterns to those found in developed countries. Although ADC have significantly decreased, NADC in men, including lung and anal cancer have shown an opposite trend. Therefore, cancer remains a concern in this population.
Funding source: Conselho Nacional de Desenvolvimento Científico e Tecnológico; the German Ministry for Economic Cooperation and Development through the German Academic Exchange Service and the Higher Education Excellence in Development Cooperation .